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Individual

COLLEEN MARIE BOTTERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
500 CITY CTR, OSHKOSH, WI 54901-4830
(920) 410-2555
Mailing address
2025 WALNUT ST, OSHKOSH, WI 54901-1857
(920) 410-2555

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
143446-030
WI
163WC0400X
Case Management Registered Nurse
Primary
143446-30
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35046600
WI
Enumeration date
04/08/2008
Last updated
09/08/2010
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